Arimidex versus tamoxifen

I have been off Arimidex (anastrozole) for almost two months, and most, if not all, the symptoms have disappeared. The joint pain is barely noticeable, but the weight gain is still there. Guess I have to stop blaming “hormonal therapy” for that. Anyway, I met with the doctor that works with my regular oncologist yesterday and we decided that I would go back on tamoxifen (Nolvadex). This is not the optimum prescribed treatment. We know that aromatase inhibitors like Arimidex and Femara (letrozole) have proven more effective in reducing the risk of reoccurrence when therapy was switched from tamoxifen after two years in postmenopausal women. We also know that it is the better recommendation for postmenopausal women. What we don’t know are the long term side effects for bone loss or other diseases that could occur years after therapy ends. Tamoxifen has been around for over 20 years, and no mysterious illnesses have surfaced, the side effects, although only accountable in small percentages, can be acutely severe; endometrial, uterine cancers and blood clots. The bone loss is not an issue.

I dug into a July 25, 2002 webcast at HealthTalk that deals with this subject. It provided clear information on hormonal therapy and the differences between Arimidex and tamoxifen. Although it confirmed my feelings the doctors made it clear that there is not one answer for all women. Your hormonal therapy needs to be discussed with your oncologist and cancer team. In addition, I need to acknowledge that in the medical world, 2002 was a long time ago and tests underway then still confirm today the benefits of Arimidex over tamoxifen in postmenopausal women. (Arimidex is not prescribed for premenopausal women).

Tamoxifen interferes with the estrogen in the body thus preventing disease. This drug clearly reduces the risk of breast cancer in high-risk women. Arimidex, or Femara works by interfering with estrogen production in the body; the adrenal gland produces steroids that are converted to estrogen by the enzyme known as aramatase, the drug eliminates estrogen from this other source. Therefore, it is most effective in postmenopausal women who no longer produce estrogen from the usual source.

So here I go taking charge of my own treatment again. Every time I go to my oncologist and meet with a new assistant or doctor, they go over the fact that I declined radiation therapy like it’s a disclaimer. The bottom line though is that I am in charge and 20 years from now I have only me to answer to. I can say that because my 15-year-old son will be fully grown and out of the house and have better things to do than challenge his mother. That is another topic and one that induces the need for much therapy and a support group for mothers of teens. Do you know a good one?

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ABOUT THE AUTHOR

Kathy-Ellen Kups, RN

Kathy-Ellen is a Registered Nurse living in Michigan. In 2003, Kathy-Ellen was diagnosed with stage three breast cancer. She was cancer-free from April 2004 until December of 2013 when it was discovered that...read more